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Biomedical subjects

K Hiroshima

Publications and source records attributed to K Hiroshima.

At least 55 records · Page 3Linked to original sources
PubMed1999

Pulmonary blastoma: report of a case.

A 30-year-old woman was admitted to our hospital for investigation of an abnormal shadow in the right pulmonary hilus on a chest X-ray film. A percutaneous needle biopsy was performed, which revealed pulmonary blastoma. A right upper lobectomy was performed and the pathological stage was confirmed to be IIIa (T3N0M0). An analysis of preoperative cytological specimens showed that epithelial tumor cells with thin cytoplasm were either tubular or papillary, while some mesenchymal tumor cells with elliptic and spindle-shaped nuclei were also found in the necrotic background. Thus, pulmonary blastoma should be considered when a two-cell pattern consisting of both epithelial and mesenchymal components is observed. DNA analysis was performed on previously identified areas of the epithelial or sarcomatous components, using a microdissection method. An analysis of the p53 gene by the single-strand conformation polymorphysm method showed an abnormal band with shifted mobility of exon 8 in only the sarcomatous component.

Adult↗
PubMed1999

Case report. Localized pulmonary zygomycosis without pre-existing immunocompromised status.

Pulmonary zygomycosis rarely occurs without pre-existing immunocompromised disease. A 72-year-old male was found to have a nodular shadow (3 cm x 4 cm) in the right S8 and S9 on a chest X-ray. Right lower lobectomy was performed and histological examination of the resected material demonstrated pulmonary zygomycosis. Hyphae stained positively not only with Grocott-Gomori methenamine silver staining, but also with an anti-Rhizopus oryzae polyclonal antibody.

Aged↗
PubMed1999

Smoking before surgery predicts poor long-term survival in patients with stage I non-small-cell lung carcinomas.

PURPOSE: The majority of lung carcinoma patients requiring resection have smoking habits prior to surgical treatment, and the correlation of smoking with postoperative complications is well known. However, few studies have investigated the correlation between long-term survival and cigarette smoking in patients with primary, resected lung carcinoma. We analyzed the relationship between clinical factors, including cigarette smoking before surgery, and 10-year survival in stage I non-small-cell lung carcinoma (NSCLC). PATIENTS AND METHODS: Cigarette smoking habit and other factors influencing either the overall survival or the disease-specific survival rates of patients with stage I primary, resected NSCLC were evaluated according to the Cox proportional hazards model using a total of 369 patients with stage I-NSCLC. RESULTS: Comparison of the cause of death in patients with 30 or more pack-years and patients with less than 30 pack-years showed significant differences in the prevalence of recurrent disease and onset of nonmalignant disease. Multivariate analysis demonstrated significant correlations between overall survival and age and pack-years. Disease-specific survival showed significant correlations with age, tumor classification, and visceral pleural invasion. CONCLUSION: Smoking pack-years is an important clinical prognostic factor in evaluating overall long-term survival in patients with stage I primary, resected NSCLC.

Aged↗
PubMed1999

Human pulmonary dirofilariasis: report of six cases.

We report six cases of pulmonary dirofilariasis diagnosed at our laboratory with clinical and pathological features. The nodules of dirofilariasis were round in three cases as previously reported, however dumbbell-shaped in two cases. The nodule did not attach to the pleura in four cases. Microscopically, the nodules were granulomas composed of central coagulation necrosis and peripheral fibrosis with round cell infiltration, histiocytes, and multinucleated giant cells. Necrotic pulmonary artery with single or multiple sections of degenerated nematode was observed in the center of the nodule. Dilated bronchioles with inflammation were observed in the nodule in four cases. Collapse of the alveoli, organizing pneumonia, hemosiderin-laden macrophages were observed around the nodule. We suppose that the nodule is not an infarction but a granuloma caused by antigen released from the nematode. Because the pulmonary dirofilariasis is difficult to be differentiated from primary or metastatic lung carcinoma, and the inflammation exists around the nodule, the nodule should be removed surgically.

Aged↗
PubMed1999

[A case of preoperatively diagnosed primary pulmonary leiomyosarcoma].

A 29-year-old woman had been suffering from right back pain for 3 months. Chronic pulmonary thromboembolism was suspected and she was referred to our hospital. She presented with no risk factors for thromboembolism, and during the previous 6 months had lost 4 kg in body weight. Chest radiography showed nodular shadows in the lower field of the right lung. Contrast-enhanced computed tomography demonstrated a filling defect in the right pulmonary artery and nodular lesions in the lower field of the right lung, which were considered to be signs of pulmonary infarction. Absence of perfusion into the right lung was demonstrated by a perfusion scan. Right heart catheterization showed normal pressure in the pulmonary arteries, and pulmonary angiography showed an abrupt cutoff of the right pulmonary artery, which was similar to the finding of pulmonary thromboembolism. A transvenous catheter suction biopsy was performed in the right pulmonary artery and the histopathologic findings yielded a diagnosis of leiomyosarcoma. The patient underwent surgical resection under total cardiopulmonary bypass. A large tumor completely filled the right main pulmonary artery and invaded the posterior wall of the pulmonary trunk close to the left main pulmonary artery. Primary pulmonary leiomyosarcoma is a rare tumor and its prognosis is very poor. Radical surgical resection is the only effective treatment, but early diagnosis is very difficult. Transvenous catheter suction biopsy is a useful procedure for the early diagnosis of pulmonary artery sarcoma.

Adult↗
PubMed1998

Detection of serum factors enhancing cell mutability from lung cancer patients by application of hypermutable human RS cells.

A search for serum factors that modulate the mutability of human cells has been attempted in the peripheral blood of lung cancer patients. Factors were separated by dye-ligand chromatography and first identified as those exhibiting the ability to enhance the frequency of drug-resistance mutations in human RSa cells. The frequency was assessed by estimation of the cloning efficiency of mutant cells resistant to ouabain-mediated cell killing (OuaR) after irradiation with far-ultraviolet light (UV, mainly 254-nm wavelength). Pre-culture of cells with medium containing the factors prior to UV irradiation led to about a 19- to 37-fold increase in the OuaR mutation frequency compared with that of cells irradiated but not treated with the factors. The enhancing activity was detected in the serum of all 7 lung cancer patients, although the serum itself, which had not been treated with chromatography, had little or no enhancing activity in all patients. No enhancing activity was detected in serum preparations from healthy donors. The enhancing activity of lung cancer serum factors on UV-induced mutagenicity was next confirmed by detecting an enhancement of K-ras codon 12 base substitution mutations in human RSb cells, as analyzed by polymerase chain reaction (PCR) and differential dot-blot hybridization. Our results, together with previous findings on suppression of mutagen-induced mutagenicity by human interferons, suggest the existence of extracellular factors that modulate the mutability of human cells.

Adult↗
PubMed1998

Calretinin-like immunoreactivity in the regenerating periodontal ruffini endings of the rat incisor following injury to the inferior alveolar nerve.

Regeneration of calretinin (CR)-like immunoreactive (IR) nerve fibers was investigated in the periodontal ligament of the rat lower incisor following resection of the inferior alveolar nerve (IAN). In addition, the degeneration and regeneration processes of periodontal nerve fibers were examined by immunohistochemistry for protein gene product 9.5 (PGP 9.5), a general neuronal marker. In normal animals, the periodontal nerve fibers showing PGP 9.5-like immunoreactivity (LI) formed either periodontal Ruffini endings with expanded arborization and thin free nerve endings in the alveolar half of the ligament. Thick CR-IR nerve fibers also appeared in a dendritic fashion in the same region, but thin CR-IR nerve fibers were rarely observed. Five days following resection of the IAN, a major population of PGP 9.5-IR and all CR-IR nerve fibers disappeared except for some thin PGP 9.5-IR nerves in the periodontal ligament. Regenerated PGP 9.5-IR nerve fibers appeared around 7 days following resection, in contrast to a very small number of regenerated CR-IR nerve fibers. Around 14-21 days following resection, the number and terminal morphology of regenerated PGP 9.5-IR nerve fibers were comparable to those observed in normal animals, but the number of regenerated CR-IR nerve fibers was still smaller than that of normal animals. The number of regenerated CR-IR nerve fibers increased to return to normal by 56 days following injury. The delay of expression of CR-LI in the regenerated periodontal Ruffini endings suggests that functional recovery of periodontal Ruffini endings occurred after the completion of the regeneration of periodontal nerve fibers.

Animals↗
PubMed1998

Levels of soluble Fas in patients with myocarditis, heart failure of unknown origin, and in healthy volunteers.

This study showed that serum levels of sFas were elevated in patients with myocarditis, and that this elevation was correlated with sIL-2R level as a marker of T-cell activation. Therefore, sFas levels may be associated with T-cell activation in patients with myocarditis, and elevation of sFas may inhibit apoptosis in activated T cells, leading to persistent cell-mediated destruction of myocytes in myocarditis.

Adult↗
PubMed1998

Serum anti-p53 autoantibodies in primary resected non-small-cell lung carcinoma.

Mutated p53 proteins accumulate in the nuclei of tumor cells, and anti-p53 autoantibodies are found in the sera of patients with non-small-cell lung carcinoma (NSCLC). We analyzed the correlation among serum anti-p53 autoantibodies, immunohistochemical staining for p53, and clinical features (age, gender, smoking history, histological type, differentiation, stage, T factor, tumor size, and N factor) in resected non-small-cell lung carcinomas. A total of 62 cases of resected NSCLC were studied (43 men and 19 women; 33 adenocarcinomas, 21 squamous cell carcinomas, 8 large-cell carcinomas). Preoperative serum titers of anti-p53 autoantibodies were detected in 13/62 cases (21.0%). A correlation between histological type and positive titers of serum p53 autoantibodies was seen (large-cell carcinoma versus squamous cell carcinoma and adenocarcinoma, P = 0.031, chi2-test). Out of 25 cases, 10 (40%) with positive immunohistochemical staining for p53 had positive titers, whereas 3 positive titers were found in 37 patients with negative immunohistochemical staining for p53 (P = 0.0025, chi2-test). Serum titers of anti-p53 autoantibodies were present in approximately 20% of the cases of NSCLC, and overexpression of p53 protein in tumor cells was detectable in approximately 40%. Serum anti-p53 autoantibodies may be a clinical parameter for the presence of p53 mutations and p53 overexpression in NSCLC patients.

Adenocarcinoma↗
PubMed1998

Synchronous and metachronous lung carcinomas: molecular evidence for multicentricity.

The present study is aimed to evaluate the genetic evidence for multicentricity of synchronous and metachronous multiple lung carcinomas. Nineteen cases of synchronous multiple lung carcinomas and 11 cases of metachronous multiple lung carcinomas were analyzed for p53 protein overexpression by immunohistochemistry (DO-7) and for genetic abnormality of the p53 gene by loss of heterozygosity (LOH) at chromosome 17p and by polymerase chain reaction (PCR)-single-strand conformation polymorphism (SSCP) analysis. They were also analyzed for K-ras mutation. DNA from three patients was also sequenced by the dideoxy sequencing method to confirm the presence of mutations and determine the base substitutions. Different spectrums of genetic changes, which were evaluated by a combination of p53 mutation, LOH at chromosome 17p and p53 overexpression, were observed in 11 of 19 cases of synchronous multiple lung carcinomas (57.9%) in the present study. Similarly, five of 11 cases of metachronous multiple lung carcinomas (45.4%) showed a different pattern of genetic changes. The present data suggest that some of the multiple carcinomas have different clonal origins, although their histological types are identical, and support the use of genetic markers in the differential diagnosis between metastasis and second primary carcinoma of the lung.

Adult↗
PubMed1998

MRI evaluation of steroid- or alcohol-related osteonecrosis of the femoral condyle.

We reviewed 30 patients (46 knees) with steroid- or alcohol-related osteonecrosis of the femoral condyle. Their average age was 35 (14-61) years and the mean observation time was 7 (3-16) years. The medio-lateral extent and the anterior-posterior (AP) location of the necrotic lesion were evaluated on T1-weighted MRI and related to the collapse of the condyle. The size of the lesion was classified into three categories on the mid-coronal MRI of the femoral condyle: there were 44 small, 20 medium, and 9 large lesions. The condyle was divided into 3 zones: anterior, middle, and posterior. The location of the lesion was evaluated on the mid-sagittal image. There were 7 anterior, 9 middle, 29 posterior, 14 middle and posterior and, in 14 cases, all 3 zones were involved. 44 small lesions did not collapse, while 6/20 medium lesions and 5/9 large lesions collapsed. No lesion involving only one zone collapsed, while 4/14 lesions involving the middle and posterior zones and 7/14 lesions involving all three zones progressed to collapse. 4/6 condyles with large necrotic lesions involving all three zones collapsed. We conclude that the extent of the necrotic lesion on both the mid-coronal and mid-sagittal planes is of importance for the prognosis of osteonecrosis of the femoral condyle.

Adolescent↗
PubMed1997

Extensor tendon rupture due to Kienböck's disease.

Extensor tendon rupture as a complication of Kienbock's disease is rare. We report a case of attritional rupture of the extensor tendon to the index finger by a comminuted dorsal fragment of the lunate after Kienböck's disease in an elderly woman. Excision of the fragment and extensor reconstruction with tendon graft led to a favourable result.

Female↗
PubMed1997

Myelopathy due to hypoplasia of the atlas. A case report.

The authors report a 73-year-old woman who had spinal cord compression develop because of hypoplasia of the atlas associated with a retroodontoid pseudotumor diagnosed by magnetic resonance imaging. Radiographs of the cervical spine showed narrowing of the spinal canal at the level of the atlas and severe osteoarthrosis of the atlantoaxial joint without atlantoaxial subluxation. A remarkable neurologic recovery followed decompressive laminectomy of the atlas with posterior occipitocervical fusion. Postoperative magnetic resonance imaging showed significant reduction of the retroodontoid pseudotumor by fusion alone. The magnetic resonance imaging finding of spontaneous reduction of retroodontoid pseudotumor after posterior fusion argues against a need for transoral removal, which has a significant complication rate.

Aged↗
PubMed1997

Acetabular osteolysis and migration in bipolar arthroplasty of the hip: five- to 13-year follow-up study.

We have reviewed 65 bipolar arthroplasties of the hip in 55 patients with osteoarthritis secondary to dysplasia. The mean age at operation was 56 years (42 to 79) and the mean period of follow-up was 7.2 years (5.0 to 13.0). The average Merle d'Aubigné and Postel score before operation was 10.3 and at final follow-up 15.0. There were excellent or good results in 42 hips (65%). Migration of the outer head was observed in 50 hips (77%), most often in the group with a centre-edge angle of less than 0 degrees, an acetabular head index of less than 60%, coverage of the outer head by the original acetabulum of less than +10 degrees and after bone grafting of the acetabulum. This migration was progressive in 31 (62%) of the 50 hips, with massive osteolysis of the acetabulum in eight. The extent and progression of migration were closely associated with this osteolysis. Four hips required revision for extensive migration of the outer head with destruction of the acetabulum or severe acetabular osteolysis, and nine hips are awaiting revision for failure of the bipolar prosthetic head. The overall failure rate was 18%. We report major problems after bipolar hip arthroplasty for osteoarthritis secondary to hip dysplasia with progressive migration of the outer head and massive acetabular osteolysis at five years or more after operation.

Acetabulum↗
PubMed1997

[Suitable and successful management in preoperative deposit of autologous blood transfusion in cases of orthopedic elective surgeries].

To reveal the suitable and successful management in preoperative deposit of autologous blood, the 307 cases who had autologous blood transfusion during orthopedic elective surgery were studied retrospectively. Light body weight(less than 43 kg), predonative anemic condition(less than 11.3 g/dl in Hb concentration), and the aged(older than 68 yrs) were the main factors causing less deposit than scheduled amount. Less deposit (< 766 ml in THA), when preoperative low Hb concentration and unexpectedly massive bleeding added to it, was responsible for necessity of homologous blood transfusion. Combination of 400 ml-donation with 200 ml-donation, and gradual increase of rhEPO administration, are effective to prevent from unexpectedly less deposit.

Blood Transfusion↗
PubMed1997

[A resected case of diffuse malignant pleural mesothelioma diagnosed by thoracoscopic biopsy].

A 53-year-old male was admitted with cough and chest pain. A chest X-ray film showed left pleural effusion and a chest CT revealed irregular thickening of the pleura. Pleural fluid cytology and percutaneous needle biopsy were negative for malignancy. Thoracoscopic findings revealed fibrin network with pleural effusions and yellow-white pleural thickening, but neither nodules nor masses were found. The thoracoscopic biopsy specimen from the pleural thickening resulted in the diagnosis of malignant pleural mesothelioma. Left pleuropneumonectomy with mediastinal lymph node dissection was performed. Since detailed inspection of the pleural cavity and taking large biopsy samples under thoracoscopic examination are possible, we consider thoracoscopic biopsy to be a useful method for obtaining diagnosis of malignant pleural mesothelioma. Pleuropneumonectomy and systematic lymph node dissection of the pulmonary hilum and mediastinum were believed to be necessary for the surgical treatments.

Biopsy↗
PubMed1997

[Inflammatory bronchial polyps with a foreign body-like substance].

A 68-year-old male complaining of hemosputum was admitted to our hospital. Fiberoptic bronchoscopic examinations revealed bronchial polyps and a flat foreign body-like substance in the left main bronchus. A closer inspection of a biopsied bronchial inflammatory polyp showed inflammatory edema with hypervascularization in the submucosal space and inflammatory cell infiltration. Following complete removal of this foreign body-like substance, the polyps disappeared within six weeks. It is therefore feasible to assume that the polyps appeared as a reaction to this extrinsic substance. The origin of the foreign matter is not obvious because the patient had no history of aspiration and because the histological examination did not confirm that it was a foreign body. The substance could have been formed out of the organization and calcification of some secretes in the bronchus.

Aged↗